Healthcare Provider Details

I. General information

NPI: 1376523274
Provider Name (Legal Business Name): CABRINI CENTER FOR NURSING AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 07/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 BROADWAY
DOBBS FERRY NY
10522-2835
US

IV. Provider business mailing address

542 E 5TH ST
NEW YORK NY
10009-6531
US

V. Phone/Fax

Practice location:
  • Phone: 914-693-6800
  • Fax: 914-693-1731
Mailing address:
  • Phone: 212-358-3000
  • Fax: 212-358-3063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7002350N
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier00310536
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: MS. MARY DEVLIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 212-358-6266